Visiting Angels Care Also known as Visiting Angels

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always have a clear shared vision, strategy and culture. Leaders demonstrated a strong commitment to promoting the service’s core values and expectations of care. However, feedback from some staff highlighted concerns regarding the workplace culture. One staff member said, “I don’t feel Visiting Angels is well-led, some staff don’t want to visit the office as they feel uncomfortable. I have passed my concerns onto management, but nothing is done.” In response, leaders outlined their objectives for service improvement and proposed strategies to strengthen the culture within the service.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. Staff feedback regarding the culture of the service was varied. While some staff spoke positively about their experiences, others did not feel the culture consistently supported them. One staff member told us, “No I don't feel supported by the service, I’ve only met my manager on a few occasions. When I have gone into the office, I have never felt welcomed.However, other staff spoke positively about the support they received. One staff member said, “Yes [manager] is great and very supportive, [manager] always checks on you to make sure you’re happyand ok.” We found leaders were open and responsive to feedback and provided prompt updates regarding actions taken and improvements made.

The provider did not always foster a positive culture where people felt they could speak up and their voice would be heard. Some staff reported barriers to speaking up within the service. Although all staff felt able to raise concerns around safety of people, some staff expressed that their feedback around aspects of care and service delivery were not consistently listened to, acted upon or used to drive improvements in practice. However, staff had knowledge on whistleblowing procedures and policy. One staff member told us, “I have completed safeguarding training and know the internal whistleblowing policy. If I ever see anything concerning, I report it immediately to my manager or then relevant local authority."

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. The service employed a diverse team of staff and had policies and procedures to help them make sure there was equal opportunities.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. Overall, governance systems were not consistently effective. While around half of people we spoke to told us the service was well managed, others raised concerns about communication, including unexplained missed calls, short-notice changes to carers and a lack of continuity in care on occasion. Staff feedback also reflected concerns about staff changes, inconsistent rota planning and pressures around scheduling, which at times impacted staff travel and punctuality. We identified issues in care planning and risk management, including variability in the quality of care records, delays in uploading information and risks not always being clearly identified or addressed. In addition, audits had not consistently identified gaps in care and medication records, meaning staff did not always have access to accurate and reliable information. Some staff also reported irregular supervision and a mixed staff culture. Although no harm was identified, these issues indicated areas of improvement were required, as governance systems were not always robust in ensuring safe, consistent and well-coordinated care. These concerns were raised with the service, who acknowledged them and described the steps they would take to drive improvement.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. Where necessary, external health and social care professionals would be or had been contacted for further support and advice or kept up to date with developments. The provider gave us examples of how they worked together with the person, the family and external professionalsto achieve positive outcomes for people. For example, initiatives such as a ‘chatty café’ and a ‘dementia café’ have been arranged within the local community to support people and their loved ones to engage socially with others who have shared lived experiences and reduce social isolation through belonging. The registered manager told us, “It’s really important we support the people and their families. It’s about being there as someone who will listen and understand what people are going through.” Through the service’s charitable initiatives and activities, they have raised significant funds to support local organisations.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research. We saw evidence staff had had opportunities to give feedback and contribute to the overall development of the service. The registered manager and director demonstrated a commitment to ensuring the service operated in line with best practice guidance. Staff spoke about and reflected the organisation’s core values within their roles. The provider was proactive in exploring and implementing innovative approaches to improve outcomes for people, including the use of technology to monitor and support hydration and the introduction of smart health monitoring devices. The director was actively engaged within the local community, delivering talks and sharing learning to promote effective home care. The development of the service was informed by the director’s own experience of poor-quality home care, which had driven their commitment to delivering high-quality, person-centred support.